Breathtaking evolution in health advice

 

"Diet. One of the most significant shifts has concerned dietary fats. Having been schooled in research-based nutrition and health during my first job writing science in Minneapolis from 1963 to 1965, I cheered the 1977 Dietary Goals issued by the Senate Select Committee on Nutrition that urged Americans to eat less high-fat meat, butter, eggs and refined sugar and eat more fruits, vegetables and complex carbohydrates. The report fostered a dietary change that was already underway to replace heart-damaging saturated fats from animals, like butter and lard, with less saturated vegetable-based margarines and other solid vegetable fats.

Then studies found the trans fats in these hydrogenated vegetable products were even more damaging to arteries than animal fats. Dietary recommendations evolved to feature olive oil, a mainstay of a Mediterranean style of eating, and other unsaturated fats like canola, grapeseed and nut oils. More recently, dietary advice has shifted away from labeling foods as “good” or “bad” and focusing instead on overall patterns of eating that promote good health. But time will tell whether specific dietary fats, or the much vaunted Mediterranean diet currently embraced by many doctors, will fall prey to future findings.

Smoking. I’m very proud of the fact-based campaign I waged in The Times to curb Americans’ most dangerous yet readily avoidable habit. I reported on every new finding of smoking’s health-damaging effects and suggested paths to quitting. I hope I played a role in the albeit painfully slow decline in smoking by adults, from its peak of 42 percent in 1964 to 14 percent in 2019, the latest statistics from the Centers for Disease Control and Prevention. Alas, the recent resurgence of smoking by young adults after a 30-year decline is truly alarming. It remains to be seen where vaping and marijuana smoking will take us.

Surgery. Early in my career, radical mastectomy was the gold standard for treating breast cancer, and I recall saying that would be my choice if I got this disease. Little by little, through large, costly clinical trials, this body-deforming operation has been almost entirely replaced by early detection and minimal surgery, often followed by radiation and chemotherapy, while survival rates have soared.

Likewise, I’ve witnessed major improvements in surgery to remove cataracts (now an outpatient procedure); replace hips, knees, shoulders, elbows and even finger joints crippled by arthritis; and prevent heart attacks and strokes by bypassing obstructed arteries. Not to mention the ability to transplant organs between genetically different people, or even from animals to humans. Today, most recipients of heart and lung transplants achieve long-term benefits.

Pediatric surgeons now operate to correct or minimize major potentially fatal defects, including spina bifida and obstructed airways, while babies are still in the womb. Intrauterine gene therapy, now being tested in fetal animals, is likely next. And bariatric surgeons can now safely facilitate substantial weight loss in teenagers and adults with health-threatening obesity when dietary changes don’t suffice.

Mental health. The closing of most psychiatric hospitals and deinstitutionalization of people with serious emotional disorders during the 1950s and ’60s lit a fire under long-needed efforts to develop better therapies for mental illness. There are now many effective medications and other treatments for common conditions including bipolar disorder, depression, anxiety, attention deficit hyperactivity disorder, post-traumatic stress disorder and psychosis.

The recognition of autism as a spectrum disorder is fostering greater understanding of children and adults with this condition. Leaders in their field, like the animal scientist Temple Grandin and the actor Sir Anthony Hopkins, who have talked openly about being on the spectrum, are helping others find acceptance in society."